The guttural pouch is a structure that is only found in equine species. It is an outpouching of the Eustachian tube, the tube that connects the ears to the nose and mouth and helps to regulate air pressure. Guttural pouch empyema is a condition in which pus- and bacteria-containing secretions accumulate in the guttural pouch.

The condition usually develops after a bacterial infection of the upper respiratory tract. Signs include intermittent nasal discharge that contains pus, painful swelling, and in severe cases, stiff head carriage and noisy breathing. Fever, depression, and loss of appetite may or may not be seen. A diagnosis can often be made after endoscopic examination of the guttural pouch. Guttural pouch empyema should be considered a Streptococcus equi equi infection until proven otherwise, and isolation or quarantine procedures should be instituted in affected horses until the bacterial culture results are obtained.

Antibiotic therapy alone will not resolve the infection; the guttural pouch must be rinsed out by lavage. Guttural pouch empyema may compress the throat and produce upper airway obstruction. If this occurs, a tube through the trachea (tracheotomy) may be necessary to provide a temporary alternative airway. If guttural pouch empyema is not treated, the material in the pouch continues to provide a source of bacteria for infection.

Last full review/revision July 2011 by Bonnie R. Rush, DVM, MS, DACVIM; Neil W. Dyer, DVM, MS, DACVP; Joe Hauptman, DVM, MS, DACVS; Ned F. Kuehn, DVM, MS, DACVIM; Stuart M. Taylor, PhD, BVMS, MRCVS, DECVP; Wendy E. Vaala, VMD, DACVIM; Maureen H. Milne, BVMS, MVM, DCHP, MRCVS